CDC Clarifies Opioid Guideline Dosage Thresholds

On March 15, 2016, the CDC issued its final Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.(www.cdc.gov) The guideline is specifically intended for use by primary care health professionals who are treating patients with chronic pain (i.e., pain lasting longer than three months or past the time of normal tissue healing) in outpatient settings.

However, there’s been recent concern that when implementing the guideline, some health care professionals may have applied the guideline’s dosing protocol — which lays out what the agency considers to be appropriate thresholds for initiating and titrating opioid dosages as calculated by conversion to morphine milligram equivalents per day (MME/day) — to buprenorphine used to treat substance use disorder.

The CDC guideline explicitly stated that the dosage thresholds provided pertain solely to opioids used to treat chronic pain: “The recommendations are not intended to provide guidance on use of opioids as part of medication-assisted treatment for opioid use disorder.”

The agency sent a letter to the American Society of Addiction Medicine(www.asam.org) on Jan. 4 to further clarify this distinction.